dr.shar
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Medical students at a major teaching hospital are routinely assigned to observe obstetric patients and to assist during delivery. When a male medical student introduces himself to the obstetric patient, the patient becomes agitated and requests that no students be present during her delivery. The patient had been informed, prior to admission, that this was a teaching hospital and that a student would be assigned to her case. When informed of the patient's refusal, the attending physician in charge should
A ask the patient's husband for consent
B assign a female medical student to observe
C not allow any medical students to observe this patient
D have the patient's nurse seek permission
E have the student approach the patient again and explain the necessity for student observation
F have the student observe in the background as part of the health care team
G meet with the patient and discuss the value of observation in medical training
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| aash
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Ans is c
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| aash
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ans is c
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| dr.shar
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why not B
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| mjl1717
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Pt said "no students" end of story
answer-c
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| docofthebigapple
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patient has the final say. Answer is c.
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| Ahab
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Why not G?
Ill agree that the patient has the right to decide on tx, however it is a TEACHING hospital, in a facility that is purposly designed to have the function of BOTH treatment and teaching does any patient have the right to refuse students, end of story?
Remember, the student will not be performing or assisting in the delivery, only observing
I believe that the attending needs to approach the patient, tell her it is a teaching hospital where students need to learn the skills necessary so that they may be able to practice medicine and without this chance to observe (in general, not this case exactly) their medical training will suffer. If the attending then believes that more harm than good will come from medical students observing this patient then it is in everyones best interest not to allow students.
Can the patient refuse a black nurse? (not an inflammatory statement but I believe it is in the same vein as this patients refusal)
Coments?
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| mash
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ahab, pt requests that no students be present during her delivery.
she did not say dat she dint want 'male' students to be present ...
(so, the ques of race or color or sex does not arise)
the ans is C
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| Ahab
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it is the NO students bit that I am specifically addressing when it is in the context of a teaching hospital, there should be at least a duty to explain to the patient the real benefits to allowing students to observe, otherwise we may as well all stay in bed all day 
My addressing of a black nurse is probably leading people the wrong way, what i am trying to say is does a patient have the right to pick and choose anyone they want to be present for the procedure based on their autonomy. Can they demand that the attending have 15+ years experience? Or that the residents graduated from an ivy league school?
Option G does not force the student into the room, it merely takes what is a normal occurance (students observing) that the patient is anxious about, and expanding the patients knowledge of student teaching in the hope that she will then understand and accept (form of desensitisation?) the student to remain. G does still allow refusal of student but only after further exploration
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